In our recent Q&A session, industry experts Kelig Aujogue and George Robbins tackled the pressing issues of fraud, waste, and abuse in health insurance. They revealed that 5% to 10% of private medical insurance claims may involve fraud, with variations across European countries.
Kelig highlighted the transformative role of artificial intelligence (AI) and machine learning in identifying inappropriate billing practices, such as unbundling procedures for higher payouts. These technologies can analyse insurer data to spot emerging trends in fraudulent behavior, enhancing claims processing efficiency and improving fraud detection in healthcare.
The discussion also touched on waste and leakage, emphasising how technology can streamline operations and improve fraud detection. Notably, George pointed out the similarities between health and pet insurance, as both sectors face related challenges.
As we look to the future, Kelig and George stressed the importance of real-time detection methods and modern AI solutions in combating fraud.
For valuable insights into the future of fraud prevention in the insurance industry, we invite you to watch the full Q&A session. Discover how technology is shaping the landscape of health and pet insurance!